Suicidal behaviour has historically been stigmatised, which has hampered its detection and treatment.1 In the last few years, concern about this phenomenon has grown, with the political agenda focusing on global initiatives. In its Mental Health Action Plan 2013-2020, the WHO stressed that suicide prevention was a priority, with the aim of reducing suicide rates by 10% by 2020.2 Likewise, the United Nations, in its Sustainable Development Goals for 2030, included suicide prevention as one of its aims for global health and well-being.3
Currently, several countries have developed national and local suicide prevention programmes, which act on various factors with scientific evidence supporting their possible influence on this behaviour. These programmes have been classified into universal prevention programmes, aimed at the entire population (for example, restricting access to means or methods of suicide); selective prevention, aimed at the “vulnerable” population with a higher biological, psychological or socioeconomic risk of suicidal behaviour (for example, suicide hotlines); and indicated prevention, targeting the high-risk population with signs or symptoms suggesting potential suicidal behaviour or people who have made a prior suicide attempt (for example, community-based follow-up and support after the suicide attempt).4,5
Programmes with demonstrated effectiveness in reducing suicidal behaviour include intervention strategies involving multiple stakeholders (for example, the healthcare sector, education, and the media, among others) and/or that combine several intervention components such as surveillance systems for the early detection of cases, healthcare at the moment of the crisis, specialised follow-up after the crisis, and training of professionals in the phenomenon, among others.5
The 2011-2015 Health Plan of Catalonia was a pioneer in prioritising the problem of suicidal behaviour. As a health goal, the plan proposed reducing death from suicide by 2020.6 The new 2016-2020 Health Plan highlights mental health as a priority and selects suicide prevention as its main project.7 The Catalonia Suicide Risk Code Programme (CSRC Programme) programme is a an indicated prevention strategy to combat suicidal behaviour, and is the main intervention of these health policies. The CSRC Programme aims to increase survival among the population attended for suicidal behaviour and to prevent repeat suicide attempts, with a view to reducing death from suicide. To do this, the strategy focuses on early detection and treatment, as well as specialised follow-up after hospital discharge, among persons who have attempted suicide and/or are at severe risk of suicide. 8
The WHO has stressed the need to assess the policies and suicidal behaviour prevention programmes carried out by countries or regions to ensure interventions based on the best available scientific evidence, as well as to use the results obtained to improve these programmes, the formulation of recommendations, and services planning.5 Nevertheless, there are few rigorous studies assessing the effectiveness and efficiency of these programmes. 5,9,10